Active NPI
Momo Tanaka
- Veterinarian
- Norwalk, CT
National Provider Identifier
1972904498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 003963
- Practice address
- 123 W Cedar St
Norwalk, CT 06854-1917 - Phone
- (203) 854-9960
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 003963 | CT | Primary |
Addresses
Primary practice location
123 W Cedar St
Norwalk, CT 06854-1917
Mailing address
27 Fairfield Ave Apt A2
Norwalk, CT 06854-2143
Phone (919) 607-3642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003963 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1972904498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 FAIRFIELD AVE APT A2",
"city": "NORWALK",
"state": "CT",
"postal_code": "068542143",
"telephone_number": "919-607-3642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 W CEDAR ST",
"city": "NORWALK",
"state": "CT",
"postal_code": "068541917",
"telephone_number": "203-854-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAKA",
"first_name": "MOMO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "CT",
"license": "003963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.